tirzepatide vs semaglutide efficacy weight loss comparison Tirzepatide: Which GLP-1 Wins for Loss? Tirzepatide vs Semaglutide: A Comprehensive

Findings: RCTSURMOUNT-2 trial - Tirzepatide vs Placebo for Weight Loss in Diabetes, Lancet (2023) [PubMed abstract] Design: Randomized, placebo-controlled trial (N=938 | length = 72 weeks) in overweight diabetics (mean BMI 36 | mean A1C 8.02%) Treatment: Tirzepatide 10 mg once weekly vs Tirzepatide 15 mg once weekly vs Placebo Primary outcome: Coprimary endpoints were the percent change in body weight from baseline and body weight reduction of 5% or higher Results: Primary outcome (% reduction in weight): Tirzepatide 10 mg - 12.8%, Tirzepatide 15 mg - 14.7%, Placebo - 3.2% (p 35 - 68.9% Randomized treatment groups Group 1 (374 patients): Tirzepatide titrated to the maximum tolerated dose of 10 mg or 15 mg once weekly Group 2 (376 patients): Semaglutide titrated to the maximum tolerated dose of 1.7 mg or 2.4 mg once weekly Tirzepatide was initiated at a dose of 2.5 mg once weekly, and the dose was increased by 2.5 mg every 4 weeks until a maximum tolerated dose of 10 mg or 15 mg was reached

Serious adverse effects requiring immediate medical attention include signs of pancreatitis (severe persistent abdominal pain radiating to the back), symptoms suggesting thyroid tumors (neck mass, difficulty swallowing, persistent hoarseness), severe allergic reactions, or acute kidney injury (significantly decreased urination, swelling, fatigue)

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Tirzepatide escalation takes 20-24 weeks

ACS Chem Neurosci 16:818825 Dickson SL, Shirazi RH, Hansson C et al (2012) The glucagon-like peptide 1 (GLP-1) analogue, exendin-4, decreases the rewarding value of food: a new role for mesolimbic GLP-1 receptors

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